November 18, 2010

A Weighty Issue

One thing that so often crops up for people switching from canned formula to a food diet is the conundrum of weight loss/weight gain.  There is always some fear in change, and so many of us are conditioned to trust medical professionals' knowledge in all areas they choose to speak on; and to trust 'scientifically' determined ratios and amounts of calories, nutrients and so on that it can be hard to leap out of that way of thinking.  The need we so often have to be as in control of an out-of-control situation as we can (like a loved one's health) can cause us to lock us into a search for absolutes, for rules, for prognosis: "If I do X, will Y happen, and when?"

But of course nature, of which we are all a part (and we forget this sometimes too, that we are animals in an environment) does just not work this way.  Furthermore, we are all so very different.  We each respond to various formulae, and foods, differently too.  This is why prediction, prescription, growth and weight charts, calorie plans and the like are guidelines to start with at best; frightening, irrelevant and wrong for us at worst.  The best way forward always ends up being from our direct experience.

All that being said, there are some recurring themes that seem to crop up with a switch from formula to BD when it comes to the issue of weight.

Something that really gets my goat* is the habit of modern medicine to create bogus 'diagnostic' terms that really just medicalise something simple and obvious, as if by giving it a fancy, formal-sounding acronymic name some power can be achieved over it.  One such term that gives me the screaming willies** is Failure To Thrive (FTT).  It is NOT a diagnosis, any more than GERD is. It is a shorthand pointer to a description of some of a set of symptoms, that is all.  In FTT's case, it means 'not growing so well'.  So many parents whose child is 'diagnosed' with FTT have all sorts of fear put into them about caloric values and density and have a hard time even considering a way out of the formula can as a result.  Partly perhaps because one of the 'scare stories' is true some of the time at least:

Kids and adults alike can often lose weight initially when switching from canned formula to food.

So why might that be?

The most commonly presented answer points at the 'empty calorie' syndrome.  This is where despite being perhaps 'underweight' by standard measures, someone is carrying excess unhealthy fatty tissues just pumped up by the very high relative percentage of refined carbohydrates (sugars) present in canned formulae.  The body can only use or process and excrete so much of the caloric value put in because there's just too much of the one kind of caloric substance so it stores it.  As soon as the topping-up is stopped (no more formula going in) the body starts to rid itself of its toxic and unhealthy burden and switch into a different mode of assimilating nutrients.  The same thing is seen with really high-fat diets.  Our modern obesity epidemic really has two main causes - simple overeating and the composition of what we kid ourselves is food.  Many would be surprised just how much fat and sugar there is in the most innocent-seeming processed foods.

Lots of parents experiencing this will say that the child in question is technically losing weight, but is visibly less 'puffy', and developing a healthier colour.  And the thing is, it rarely seems to last very long - a couple of weeks generally before the turnaround begins.

Another possible answer is that it's just a change thing.  If you've been on formula for a while then your body gets used to it - even if there's all sorts of intolerance, vomiting, diarrhea and the whole catastrophe going on.  We are amazingly adaptable survivors and can extract sustenance when we really have to, even when it's mixed in with something that is poison to us.  So it can take a while for the body to adapt (or re-adapt) to digesting new things.  During this time some weight may be shed.

A third good reason I've heard posited is that there's a whole new lease on life going on and since feeling suddenly so much better, increased activity is just burning up all the excess calories!  I know this was part of what happened for me.  I went from gaining a little weight to a plateau and then a loss as I upped the BD but then I thought back and realised I was actually doing things I previously had not had the energy to do.

There must be other theories (please share!) but what it comes down to is that that there's a pretty common observable scenario where people making the switch lose, then gain.

So what I'm saying is, DON'T PANIC!  Of course, you must be sensible.  But a little weight loss in and of itself is not a major cause for concern.  You may feel stuck in a cleft stick - the docs say "OK, try BD, but if there's no weight gain in a month it's back to Evilvomitformula 1.5***" or your child may be at a very low baseline already and you're scared to let it go too far.  It could be of some reassurance to know that in almost every case, the turnaround to a nice steadyish weight gain happens quite quickly.

But weight, there's more! (haha)

Sometimes quite the opposite happens and this can be a bit off-putting too.  Occasionally there's a rapid weight gain, one not also associated with a length or skeletal growth.  This is not entirely desirable, but it's generally an easy fix - less food or less calorie-dense food.  Quite often in these cases it seems that the formula simply didn't absorb well, but natural food does.  And the body is hungry for nutrition and just goes mad for it.

I'll round this out by briefly returning to the subjects of FTT and weight charts.  Too often now I've heard of children who may have been preemies (we call them premmies here in Oz btw, just a pronunciation thing) or are otherwise 'small' for their age - 'adjusted' or otherwise - being measured and judged according to some standard weight/age chart, being pumped up on synthetic empty calories, and then discovering they're carrying too much weight for their bones and organs to handle.  Please remember, height and weight charts are just things made up from measurements of regular, non-special-needs folks, to find some average, and then they have a standard statistical spread applied.  Everyone's different.  Of course, if you or your loved one is an outlier on the charts then it's worth having a closer look - but it's not necessarily a problem at all.

Our human instincts are king here.  Look, feel, all the rest.  You know what's a good weight and what's not.  You have your own special chart and that of your loved ones in your head the whole time.  Trust them, and be sensible.  That is all.

*Not literally, of course.  I don't have a goat.  But I love goats and if I had one I wouldn't let anything 'get' it.
**Again, mostly not literally.  I prefer my willies a lot calmer and composed.
***Evilvomitformula1.5 may not actually exist.  Or it may.



  1. I would also have to chime in about natural fluctuations in weight that occur in the body over the course of a day. Sometimes I see nurses panic (and, as you so astutely point out, creating unneccesary panic for parents) when a child has lost, oh, 3 ozs. Hmm. And how much liquid weight does a single diaper (nappy) hold? Little things like full/empty bladders or bowels and even the weight of clothes (for older children who are weighed fully dressed but for their shoes) can have a big impact on scale numbers. Reason says that changes shouldn't normally be made on the result of one blip from a single weigh-in, yet we hear of this practice far too frequently. A calmer, more conservative approach of watching for trends over time is going to benefit a child more than knee-jerk responses that never allow him to adjust to a routine.

    Oh, and yes. Since we do have goats, I can promise that you really would adore them. They are absolutely delightful critters that you would protect from getting "gotten." Thanks for sharing your wonderful humor!


  2. Well said Rose-Marie. I average these days at 55kg (121 lbs) and am 183cm (6ft) tall so well below any norms on a weight chart. And my weight can change by up to 1.5 kgs on a single day, and over time by this amount in either direction. Goats are awesome people, aren't they?

  3. Thanks for the post Eric and the comment Rose-Marie. It is timely for us.

    Another thing to think about is making sure the scale is properly calibrated. Hard to believe, but our public health nurse ( who weighs our daughter at home) uses a scale that is only calibrated 2 times a year. It is often "wrong" (one time 9 ounces less!!) and the dietitan has wanted to make diet adjustments based on it. Hard to trust even a trend if it isn't measured correctly.